Chapter 32 EAQ: Heart Failure & Valvular Heart Disease

Which specific type of heart failure is most likely to occur at the beginning of chronic HF?

Left-sided

Which condition can cause high-output heart failure? (SATA) A. High fever B. Septicemia C. Valvular disease D. Hyperthyroidism E. Coronary artery disease

A, B, D

Which is a major compensatory mechanism when cardiac output is insufficient to meet the demands of the body? (SATA) A. Chemical responses B. Myocardial hypertrophy C. Pulmonary hypertension D. Renin-angiotensin system activation E. Sympathetic nervous system stimulation

A, B, D, E

Which is an example of the Healthy People 2020 initiative to reduce hospitalization of older adults with heart failure as the principal diagnosis? (SATA) A. Ensure that the interprofessional team provides follow-up care in the home or nursing home B. Call the hospitalized patient to assess signs or symptoms of impending heart failure C. Provide a continuing plan of care for the patient and family or other caregivers when the patient is discharged from the hospital D. For patients hospitalized for heart failure, collaborate with the case manager for discharge planning, including adequate support in the community E. Teach the patient and family or other caregiver about when to call the health care provider for health changes so that the patient can be treated at home

A, C, D, E

Which risk factor does the nurse include when providing community education about heart failure? (SATA) A. Cocaine use B. Hypotension C. Aortic stenosis D. Hypothyroidism E. Cardiac dysrhythmias F. Anxiolytic medication

A, C, E

Which is a common symptom of hypokalemia? (SATA) A. Generalized weakness B. Cool extremities C. Dependent edema D. Depressed reflexes E. Irregular heart rate

A, D, E

Which is a symptom of left-sided heart failure? (SATA) A. Hacking cough B. Dependent edema C. Distended abdomen D. Oliguria during the day E. Frothy, pink-tinged sputum

A, D, E

When reviewing the arterial blood gas (ABG) values of a patient with heart failure, the nurse suspects which cause of metabolic acidosis?

Accumulation of lactic acid

What finding does the nurse expect when assessing a patient with long standing heart failure? (SATA) A. Weight loss B. Swollen abdomen C. Third heart sound D. Shortness of breath with activity E. Awakening with breathlessness F. Productive cough with yellow sputum

B, C, D, E

Which is a symptoms of late stage aortic stenosis? (SATA) A. Polyuria B. Debilitation C. Marked fatigue D. Nocturnal angina E. Peripheral cyanosis

B, C, E

The nurse expects an elevation in which diagnostic reading in a patient with heart failure?

B-type natriuretic peptide (BNP)

Which test is used for diagnosing diastolic heart failure in a patient with a history of acute dyspnea?

B-type natriuretic peptide (BNP)

Which finding indicates to the nurse that a patient is experiencing digoxin toxicity?

Blurred vision

Which is an intended outcome of ultrafiltration when performed in a patient with renal dysfunction as a result of heart failure? (SATA) A. Increase in aldosterone B. Decrease in cardiac index C. Decrease in cardiac filling pressures D. Reduction in norepinephrine E. Decrease in pulmonary arterial pressure

C, D, E

In which category does a person with current or prior symptoms of heart failure belong according to the American College of Cardiology and the American Heart Association staging system?

Category C

In which class of the New York Heart Association (NYHA) functional classification system is a patient with refractory end-stage heart failure?

Class IV NYHA

The nurse monitors for which condition in a patient with heart failure who takes a thiazolidinedione (TZD) drug to treat diabetes?

Fluid and sodium retention

When caring for an older patient with heart failure, the nurse suspects that which medication is the cause of the patient's anorexia, fatigue, blurred vision, and changes in mental status?

Digoxin

According to the Joint Commission (2018), which is a core measure associated with the interprofessional health care team's care of patients with heart failure?

Documentation of advance care planning (advance directives) discussion with a health care provider

After teaching a nursing student about mitral valve stenosis and mitral valve regurgitation, the nurse identifies effective learning when the student identifies which common feature of both disorders?

Fatigue

For which heart condition is it most important for the nurse to discuss an advance directive with the patient?

Heart failure

Which factor is the most common etiology of heart failure?

Hypertension

After providing discharge instructions for a patient with heart failure, the nurse identifies that which statement by the patient indicates correct understanding of the teaching?

I will call the health care provider if I have a cough lasting 3 or more days.

Which parameter, determined through laboratory testing, is known as the "early warning detector" for heart failure?

Microalbuminuria

Which factor reflects the most common etiology of heart failure (HF)?

Myocardial infarction (MI)

The nurse suspects which condition when a patient reports waking with a feeling of breathlessness 2 to 5 hours after falling asleep?

Paroxysmal nocturnal dyspnea

Which is the nurses priority action when, after receiving enalapril for heart failure, a patient reports dizziness and has a blood pressure of 82/46 mm Hg?

Place the patient flat in bed

According to the American College of Cardiology (ACC) and the American Heart Association (AHA) heart failure staging system, a patient with which condition meets the criteria for category D?

Refractory end-stage heart failure

Which condition does the nurse suspect in a patient with heart failure who expectorates frothy, pink-tinged sputum.

Severe pulmonary edema

Which does the nurse consider at the start of captopril therapy that is prescribed to a patient with heart failure?

The risk for hypotension

Which beginning exercise does the nurse suggest for a patient with a diagnosis of heart failure that has stabilized?

Walking